1. A Major Collaborative Research Initiative funded by the Social Sciences and Humanities Research Council of Canada Healthy Aging in Residential Places A ERA-AGE2 project, funded in Canada by the Canadian Institutes of Health research

2. Who’s Involved  26 academic co-investigators 12 disciplines Six countries  Five union partners  Two employer association partners  Post-docs, graduate students  Community and advocacy groups

3. Our Objectives Seek practices that treat both providers and residents with dignity and respect understand care as a relationship take differences and equity into account promote active, health aging

4. Four theme areas: Approaches to Care Work Organization Accountability Financing and Ownership Group members switch for years 4 to 6

5. Overarching Methods Work organization Account- ability Approaches to Care Financing and Ownership Layers: 1. Mapping 2. Design phase 3. Rapid Ethnographies 4. Data analysis and integration

6. Why Promising Practices? Seeking positive strategies; Searching for ideas worth trying Context matters; Conditions of work are conditions of care Entire range of players matter; What works for whome, when, under what conditions

7. Dining Food cooked not only on site but in unit (Sweden, Norway, Germany) Flexible eating times, seating places (Sweden, Norway, UK) Sample plates (Canada) Small sizes (UK)

9. Dining Continued Use of local ingredients, seasonal (Canada, US, Norway) Food and drinks available all day (US) Meal plan for families (US), subsidized cafeteria for community (Norway) Resident participation in food preparation (Germany) Wine, beer and real coffee (Germany, UK, Canada)

10. Laundry Washer and dryer in each room (Sweden) Sealed laundry bag in each room (US) Laundry on premises (Canada)

11. Music Therapy Ipods (Canada) Personalized cds (Canada, UK, Norway) Staff integrating singing into daily care (Norway, Sweden) Resident choir (Norway) Dances for residents and staff (Norway, Germany)

12. Space Home physically integrated with community pool, cinema, art program and restaurant (Norway) Integration with other services (Canada, US, Sweden) Small units (Norway, Sweden, UK, Germany, US) Medicines in room (UK, Norway)

13. Space Continued Physicians (Norway), therapists (Norway, Sweden, dentist (Norway), Nurse Practitioner (US), Hairdresser (US, Canada) on site Rooms where family can stay (UK), where students live (Sweden) No nursing stations, med carts (UK) Thermal spa (Norway, US) Well-appointed, airy, comfortable staff room (Sweden, UK)

14. Division of Labour Each senior managers responsible for a specific number of residents (US) Weekly meetings to assess each resident Sweden, US) Limited division of labour (Germany, Sweden, Norway, UK)

15. Division of Labour Continued Staff decision-making (Germany, Sweden, Norway, UK) Primary contact nurses (Norway, Sweden) Integration of home-care and residential care

16. Principals? Staffing critical Small units in bigger place Staff all employees Kitchen on site Rns involved in direct care

17. Thank you www.yorku.ca/reltc